Differential diagnosis of headache in a neurological department

Headache is one of the most common symptoms patients attending a neurological department present. Although the overwhelming majority of these headaches are benign and self-limited, headache can be the initial symptom of life-threatening disorders. It is important for physicians to differentiate primary from symptomatic headaches. There are 3 types of primary headaches: migraine, tension-type headache, cluster headache. Symptomatic headaches are numerous and in most cases are not the consequence of serious diseases, however a tumour or a different cerebral disease can be taken into account. Accurate anamnesis and accurate physical examination will help in diagnosing the aetiology of headache. In most cases, neurological and physical exams are normal. Anamnesis is therefore the key to a correct diagnosis.